Automatic Myocardium Segmentation in Delayed-Enhancement MRI with Pathology-Specific Data Augmentation and Deep Learning Architectures

Abstract

The extent of myocardial infarction (MI) can be evaluated thanks to delayed enhancement (DE) cardiac MRI. DE MRI is an imaging technique acquired several minutes after the injection of a contrast agent where MI appears with a bright signal. The automatic myocardium segmentation in DE MRI is quite challenging, especially when MI is present, since these areas usually showcase a heterogeneous aspect in terms of shape and intensity, thus obstructing the myocardium visibility. To overcome this issue, we propose an image processing-based data augmentation algorithm where diverse synthetic cases of MI were created in two different ways: fixed and adaptive. In the first one, the training set is enlarged by a specific factor, whereas in the second, the method receives feedback from the segmentation model during training and performs the augmentation exclusively on complex cases. The method performance was evaluated in single and multi-modality settings. In this latter, information from kinetic images (Cine MRI), which are acquired along DE MRI in the same examination, is also used, and the extracted features from both modalities are fused. The results show that applying the data augmentation in a fixed fashion on a multi-modality setting leads to a more consistent segmentation of the myocardium in DE MRI. The segmentation models, which were all UNet-based architectures, can better relate MI areas with the myocardium, thus increasing its overall robustness to pathology-specific local pattern perturbations.